S29 Sexual problems in patients who were operated and a DJ stent was inserted in related to the ureteral stone

Objective: To evaluate the impact of ureteral stent insertion following semirigid ureterorenoscopy (URS) in patients with perirenal fat stranding (PFS) due to ureteral stones. Material and methods: Data of 600 patients who underwent URS were analyzed retrospectively. Seventy-two patients detected to have PFS accompanying ureteral stone were included. Patients who did not undergo double J (DJ) stent insertion following semirigid URS were classified as Group I (n: 52), while those who underwent stent insertion were classified as Group II (n: 20). Side distribution; localization of the stones, stone size, presence of fever, urinary tract infection (UTIs) and urosepsis rates were compared in the two groups. Results: The average age of the patients was 44.4 (20-71) years. Male/female ratio and side of the stone location showed similar distribution in both groups (p > 0.05). Fever occurred in 23 cases (44.2%) in Group I and in 15 cases (75%) in Group II (p = 0.038). UTIs occurred in 15 cases (28.9%) in Group I and in 12 cases (60%) in Group II (p = 0.03). Urosepsis presented in 3 (5.8%) and 5 (25%) of the patients in Group I and II, respectively (p = 0.033). Conclusions: According to our results, ureteral DJ stent insertion following URS in patients with PFS due to ureteral stone caused an increase on postoperative infection related complications.

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COMPARISON OF EFFICACY BETWEEN LASER AND PNEUMATIC LITHOTRIPSY FOR URETERAL STONE MANAGEMENT: A SYSTEMATIC REVIEW AND META-ANALYSIS

Indonesian Journal of Urology ◽

10.32421/juri.v28i2.743 ◽

2021 ◽

Vol 28 (2) ◽

pp. 187-193

Author(s):

Dillon Martino Wicaksono ◽

Doddy Moesbadianto Soebadi ◽

Wahjoe Djatisoesanto ◽

Fikri Rizaldi

Keyword(s):

Ureteral Stone ◽

Meta Analysis ◽

Laser Lithotripsy ◽

Forest Plot ◽

Screening Process ◽

Pneumatic Lithotripsy ◽

Plot Analysis ◽

Stone Free Rate ◽

Dj Stent ◽

Free Rate

Objective: This study aimed to evaluate the efficacy of ureteroscopy lithotripsy (URS) using laser lithotripsy compared to pneumatic lithotripsy for ureteral stone management. Material & Methods: A systematic search was conducted in PubMed and ScienceDirect. The search and screening process in this study followed the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guideline to include relevant RCTs. The included studies were assessed for their risks of bias using the Cochrane risk of bias tool 2 (RoB 2). The comparison of outcomes, which includes stone-free rate, DJ-Stent use, and mean fragmentation time between laser and pneumatic lithotripsy was analyzed using Review Manager 5.4. Results: A total of 11 RCTs evaluating a total of 235 patients with ureteral stone were analyzed in this review. Compared to pneumatic lithotripsy, laser lithotripsy has a significantly higher stone-free rate (OR 2.39, 95% CI 1.78-3.21, p < 0.001), longer mean fragmentation time (MD 4.11, 95% CI 3.17-5.04, p < 0.001), and lower DJ stent use rate (OR 0.53, 95% CI 0.36-0.76) based on the forest plot analysis. Conclusion: Patients undergoing laser lithotripsy have a higher stone-free rate, a lower DJ stent use rate, and albeit a longer mean fragmentation time compared to pneumatic lithotripsy.

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Long surgical waiting list times are associated with an increased rate of negative ureteroscopies

Canadian Urological Association Journal ◽

10.5489/cuaj.7199 ◽

2021 ◽

Vol 15 (12) ◽

Author(s):

Daniel A. González-Padilla ◽

Alejandro González-Díaz ◽

Helena Peña-Vallejo ◽

Rocío Santos Pérez de la Blanca ◽

Julio Teigell-Tobar ◽

...

Keyword(s):

Ureteral Stone ◽

Emergency Department Visits ◽

Waiting List ◽

Exclusion Criteria ◽

Stone Size ◽

Resource Limited ◽

Increased Risk ◽

Dj Stent ◽

Tomography Scan ◽

Limited Setting

Introduction: Negative ureteroscopy (NURS) is “a ureteroscopy in which no stone is found during the procedure.” We aimed to determine the association between the surgical waiting list time (WLT) and the NURS rate. Methods: We retrospectively analyzed all patients scheduled for ureteroscopy in our center between January 2017 and July 2019. The inclusion criterion was unilateral semirigid ureteroscopy for a single ureteral stone; exclusion criteria were renal-only stones, incomplete ureteroscopy, and stones >10 mm. We analyzed age, gender, body mass index, stone size, density and location, presence of a temporary double-J (DJ) stent, use of medical expulsive therapy, and WLT. Complications while waiting for surgery were also collected and analyzed. Results: We included 219 patients, 41 (18.7%) of whom had NURS. The median WLT was 74 days (interquartile range [IQR] 45–127). Variables protective against NURS were large stone size (odds ratio [OR] 0.78, 95% confidence interval [CI] 0.66–0.93), presence of a temporary DJ stent (OR 0.43, 95% CI 0.2–0.8), and radiopaque stones (OR 0.44, 95% CI 0.21–0.88). A long WLT (>60 days) increased the risk of NURS (OR 2.18, 95% CI 1.02–4.61). Complications requiring emergency department visits while waiting for surgery were documented in 58/137 (42.3%) patients with indwelling DJ stents; nonetheless, a WLT greater than the median was not associated with an increased risk of complications (p=0.38). Conclusions: Long WLT has an independent, direct, and linear correlation with NURS rates. Patients at higher risk of NURS, may be offered preoperative re-evaluation with a computed tomography scan in a resource-limited setting.

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